A Guide to User-Centered Healthcare Software Design and Development

Creating Engaged Patients

Once you have identified a specific set of primary patient users, it is time to determine what will engage those patients and keep them returning. What information and features will they value most? How must that information be presented initially and over time?

Healthcare consumers will submit their patient data only if they are motivated to do so. Any mobile application, patient portal, or online marketplace intended to engage them must be designed with these considerations in mind:

  • Design the product using well-documented interaction design patterns, as outlined for example in BJ Fogg’s model for persuasion.
  • Identify the user’s emotional needs through research techniques like diary study and journey mapping, and then design to those needs.
  • Explore the user of different engagement techniques like gamification, but rigorously test their use with real-world users in real-world context.
  • Focus on creating a trusted system that is robustly engineered, using an iterative software design and engineering process.
  • Fogg’s model on creating habits and automating behavior change is an excellent starting point, but it must go in hand with a strategic and long-term vision. Take advantage of proven, repeatable techniques for designing motivation systems, rooted in user experience design carried out by robust software engineering.

While this information will vary from patient group to patient group, the following are some of our top guiding principles for driving long-term patient engagement with patient portals.

Present Information They Want

A recent study by Sharp Rees-Stealy found that the four most frequently accessed areas of a portal by a patient differ completely from those areas accessed by a clinician. Patients used the portal for booking appointments online, engaging in secure messaging with a provider’s office, and viewing lab tests. Your own patient research may or may not match those particular findings, but if your interface does not present a clear path to the information patients are most interested in, they can become frustrated and less likely to interact regularly with the system.

Provide Immediate Value

For illustrative purposes, let’s explore how a patient with Type 2 Diabetes might use patient software. If she needs to enter a blood glucose reading, she will not be content to simply enter the data. She will want to monitor trends, see correlations with her activity levels or what she ate for lunch, and understand the implications. She may wonder: “Should I call my doctor?”, “Is this a normal reading?”, “If not, what should I do?”.

Patients with a chronic illness may deal with a large number of providers and wish to keep track of all of their contact information, upcoming appointments, and recent communications via the software. If your system can provide added value beyond simply housing basic information, you will be able to ensure patient satisfaction and uptake.

Make the Information Relatable

In a very real sense, patients and clinicians speak a different language. A doctor can quickly recognize a high cholesterol number, but a patient may have no way to interpret whether a figure is high or low (you need to put the information in the patient’s context). When designing your interface, implement illustrative techniques (such as color coding or a dashboard) that will help patients interpret and understand the metrics they find in their online file.

Below is an excellent example of a blood test result design (conducted by Wired Magazine) that color-codes and simplifies the results. It is much easier to understand than a simple black and white piece of paper with only text and numbers.

wired bloodwork example

Include Next Steps and Offer Patient Goal Tracking

While a physician might be content with simply knowing that a future appointment has been scheduled, a patient will want to know exactly when that appointment will take place. Moreover, a patient with a chronic ailment may want to track her progress over time and the ways in which she is contributing to her own healthcare via exercise of alternative treatments. If a user can see (via visual graphics) that she is losing weight or lowering her blood pressure, she will be more likely to return frequently to the software and feel empowered through its use.

Give Patients Reasons to Return

Many patients think that the idea of patient software “sounds” great, but quickly abandon it after their initial interaction. Patient software is worthless if patients aren’t entering data on a regular basis, or using it at all. Consult your patient persona and user research findings to hone in on areas that give users a reason to come back to the software again and again. These could include:

Notification Alerts:

If a patient has an upcoming appointment with a specialist, the system could send that user a message via e-mail or SMS to a mobile device. Or, if the system knows that the patient has diabetes, it could send reminders to enter a glucose reading and monitor trends.

Integration with Other Apps and Systems:

Many patients already use some sort of monitoring device — be it a step counter, a glucose monitor, a fitness and sleep tracker, or a jogging app on their mobile device. If a patient is able to upload readings directly from a medical device, fitness tracker, or mobile phone, that will encourage use and add value by reducing the amount of data entry required.

Real-Time Access to Health Info:

If a patient has just finished an appointment but has forgotten the proper dosage for the new medication prescribed, that user will want to check the portal immediately upon returning home. If the data does not appear, the patient will have to call the office, they’ll have to look up the information or check the health records, and everyone can become frustrated. Note that according to the U.S. Department of Health and Human Services, up to 80% of patients forget what their doctor said as soon as they leave the clinic, and nearly 50% of what patients do remember is actually incorrect. Full access to important notes and details on their visit is important for effective care.

Provide Access to Communities and Forums:

Patients often seek out other patients with a similar ailment for advice and comfort. If possible, consider ways to link your patient software to popular communities and forums such as www.patientslikeme.com or, at a minimum, recommend appropriate responsible forums based on the patient data (and you can put this directly in their notification alerts or in their health info taking the information on its full loop).

Allow Mobile Access:

A user who has just checked his blood pressure at a drugstore may want to immediately input that data instead of waiting until he gets home to his desktop. Consult your patient personas and user research to determine whether a mobile version of your patient software would be of value and, if so, which components of the software would be most useful on a mobile device. Then make them as responsive and mobile-friendly as possible.

Address Their Fears & Concerns

Your user research may uncover specific patient concerns or reasons why patients have not used patient portals in the past. Some common concerns we’ve heard include:

Privacy/Security:

“Who will be accessing my data and what information will they see?”

Payment:

“Will I need to pay some sort of subscription fee?” • Technology: “I’m not good with computers—what happens if I make a mistake or need help?”

Accessibility:

“I struggle to read on a computer.” Or “I’m not well enough to access the system regularly.” Or “I don’t have access to a computer.”

Patient / Doctor Relationship:

Some patients may be concerned that a portal will hinder communication with their physician. For example, if I spend time inputting information, will my doctor rely on this data rather than a face-to-face meeting or telephone conversation?

Tip: Addressing Privacy Issues Head On

Concerns about privacy aren’t going away anytime soon. Data hacking and security are in the papers all the time and credit card fraud is at least a once a year experience. Privacy and security are serious issues. Ensure that you understand and reach the appropriate balance between privacy, security, and the law. For further information read our section on Privacy and Usability.

Make it First-Use Friendly

People are notoriously fickle, particularly as software experiences proliferate and options abound. An app takes more than a few minutes to understand these days and people move on, possibly to the next one or not. As a result, it is particularly important today to design the interface in a way that first-time users can access what they need quickly and easily. Patients, in particular, can be easily turned off by a bad first impression and may never return. To ensure that an interface is usable for both first-time and repeat visitors, consider engaging experts to perform interaction design and usability testing — particularly for the primary, high-frequency, or critical tasks. Usability experts can test an existing design and provide recommendations on how the UI can be improved.

Even if your solution addresses the needs of its key patient groups and actively engages them, it can still fail if clinicians ignore it.


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